الفهرس 
Introduction
Definition, disease severity and clinical presentation of aplastic anaemiaOnly 14 pages are availabe for public view
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Abstract
Aplastic anaemia is a life threatening haematological disorder sothat a well-planned management protocol will have to be individualized for every patient along with monitoring for their progress and outcome. Bone marrow transplantation from HLA matched sibling donor is the treatment of choice but because of non-availability of matched donors and cost of treatment this approach is limited. Immunessuppresion with anti-thymocyte globulin and cyclosporine A is an alternative to bone marrow transplantation. Cyclosporine can be used alone or in combination with ATG. Combination of anti-thymocyte globulin and cyclosporine gives better results but anti-thymocyte globulin is expensive and many patients cannot afford it. Cyclosporine A is a cheap, less toxic and easily available potent immunesuppressive agent. It is widely used in treatment of aplastic anemia as single agent especially in resource poor setting. A potential practical advantage of cyclosporine alone would be that it can be administered to our patients reducing the cost of treatment. Response to cyclosporine A in our study widely differs from that in most other studies most probably due to different aetiological factors. The precise pathogenic mechanism of aplastic anaemia remains unclear. Acquired idiopathic aplastic anaemia is the most common variety, propably of an autoimmune aetiology due to suppression of haematopioesis by auto-reactive T-lymphocytes but this aetilogy seems to be different in our country and sothat response to treatment is bad. Toxic and environmental factors are the most propable aetiological factors at our society so that response to cyclosporine is different from that at other counteries. Recommendations In developing counteries like Egypt, bone marrow transplantation and anti-thymocyte globulin are not available as first line of management of aplastic anaemia and sothat cyclosporine is widely used with minimal side effects but with poor response rate. Our study recommends that the difference of the response between our study and other studies mostly returns to different aetiological factors.